Every year there are 400,000 Canadian women who receive news that their Pap test results are not normal. The voice of women physicians, The Federation of Medical Women of Canada (www.fmwc.ca) wants to change that. This month they are launching an awareness campaign aimed at physicians to urge their female patients to have a PAP test. #endcancer
Cervical cancer is the 4th most common reproductive cancer in Canadian women today.
This year, 1500 women will be diagnosed with cervical cancer and sadly 380 women will die. Cervical cancer is a malignant tumour that starts in the cells of the cervix. Malignant means that it can spread, or metastasize, to other parts of the body. Cells in the cervix sometimes change and no longer grow or behave normally. Changes to cells of the cervix can also cause precancerous conditions. This means that these cells are not yet cancer, but there is a chance that these abnormal cells might become cancerous if not treated. Most women with precancerous changes of the cervix are successfully treated and don’t develop cancer. *
Cervical Cancer is Preventable!
Most cervical cancers are diagnosed in women who have never been screened or have not been screened regularly. Screening is the only way to detect the early changes that might lead to cervical cancer. I can’t emphasize enough how important is to have a PAP test. In Ontario PAP tests are recommended at the age of 21, if the individual has ever been sexually active. If the test is normal, then screening should be done every three years.
HPV and Cervical Cancer can be prevented with vaccines.
Another way to protect against cancer is to get vaccinated against HPV, the Human Papillomavirus. It is the most common sexually transmitted infection with more than 40 types of HPV contracted through sexual intercourse, genital skin-to-skin contact and oral sex. They can infect the genital areas of men and women, including the penis, vulva, vagina, cervix, rectum and anus.
There are millions of women in Canada who still do not get regular PAP tests and/or a HPV vaccination.We are fortunate in Canada to have access to government-funded healthcare. Prevention is the best way to reduce your chances of facing a serious illness.
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Each year the diagnosis and treatment of HPV-related infections (Human Papillomaviruses (HPV)) cost the Canadian health care system more than $300 million. HPV are the cause of almost all cervical cancers, are a leading cause of other genital cancers, anal cancers, and warts, and contribute to cancers of the head and neck. Three out of every four Canadians will have at least one HPV infection in their lifetime. Not every infection leads to cancer, but medicine still is unclear as to why some people clear this virus, while others have persistent virus that then does become more aggressive.
In 2007, the National Advisory Committee on Immunization (NACI) recommended the use of the HPV vaccine for females between nine and 26 years of age to prevent cervical cancer, as well as other infections such as genital warts. That year, the Ontario Ministry of Health and Long-Term Care (MOHLTC) made the HPV vaccine publicly available, free of charge, to all grade 8 girls (13-14 years of age). In September 2012 the MOHLTC also funded a “catch-up” program to vaccinate females born between 1993 and 1998 that had not received all three HPV shots while in grade 8.
In January 2012, NACI added a recommendation for all males aged nine to 26 to receive HPV vaccine to prevent anal and genital cancers and genital warts. It also recommended HPV vaccine for all males who have sex with males since they have a disproportionately higher burden of HPV infections. Vaccinating males with HPV vaccine will also reduce the spread of HPV infection to females.
To date, the Ontario’s MOHLTC has not acted on this recommendation, and the HPV publicly funded vaccination program remains available only to females in grades 8-12. In other provinces, PEI and Alberta, the program is being funded for boys as well. Ontario needs to step up to the plate.
As a family physician and member of the Federation of Medical Women of Canada I cannot stress enough how crucial it is to expand this program to include boys!!! This is a contagious infection that has serious potential to spread and we have the tools to stop it! This is what we mean by primary prevention, stopping infection and disease, before it starts.
Currently, I am meeting with all 3 parties at Queen’s Park to discuss these issues and to encourage equitable access for all young Ontarians. It is only fair.
The Human Papillomavirus (HPV) is among the most common sexually transmitted viruses in the world with some strains leading to various cancers as well as external genital warts.
What this really means is that we now understand what is causing cancer in these regions. It’s very exciting, because if we understand what causes a cancer, we can begin to prevent it.
According to Health Canada, as many as 75% of sexually active men and women will have at least one HPV infection in their lifetime, with the highest rate found in people under 25. What
we don’t fully understand is why some people clear the infection and never get cancer while others have persistent infections, which leads to abnormalities. Cervical cancer is the most common HPV- associated cancer worldwide, so the majority of HPV research has
been focused on understanding the role of HPV and cervical disease.
Therefore the first trials involved girls and women. As a result, when the
vaccine was introduced in 2006 in Canada, it was launched as an immunization programme for school aged girls. However, as research continued, much more is now known about the role of HPV in causing cancers and disease in males. Therefore in 2012, the National Advisory Committee on Immunization reviewed its’ recommendations and now recommends the HPV vaccine not only for girls and women but also for boys and
men. It is so exciting that we now have a vaccine that will reduce the risk of cancers in
both sexes. How do we know this? In my next blog, I will take a look at some of the published
research findings, which show how effective vaccination really is!